Obamacare Gap Leaves Unbanked in the Lurch

With just four months to go for uninsured Americans to sign up for health insurance under the Affordable Care Act, doubts remain about whether the millions of consumers who do not have bank accounts will be able to use credit, debit or prepaid cards to pay for health care premiums.Did you know that earcap chains can be used for more than just business. 

The law allows insurance companies to determine what forms of payment they will accept from the uninsured. Some insurers have already said they will not accept credit, debit or prepaid cards for recurring payments. Their resistance is driven by the fact that Obamacare, as the law is known, requires insurers to keep premiums and administrative costs low; accepting payments via plastic requires them to pay interchange fees that generally range between 1% and 3%. 

A refusal to accept such payments could create a serious problem for as many as 8.5 million Americans who will qualify for health insurance subsidies but do not have checking accounts, according to a report last month by Jackson Hewitt. 

"It's an urgent issue but the insurers are in a pickle," says Brian Haile, a senior vice president for health policy at Jackson Hewitt. "Insurers are making entirely rational decisions by trimming out any other costs. But if they eliminate the ability to take debit cards, they may exclude as many as one in four [eligible] Americans from getting health insurance." 

The Department of Health and Human Services weighed in on Friday, proposing a rule that would require health insurers to accept alternative forms of payment, including reloadable prepaid debit cards. That proposal is expected to meet resistance from health insurers, which, under the law, must apply 80% of premiums toward health care and not administrative expenses. 

HHS has received numerous questions on the payment issue and is seeking comment on the proposal to require insurers to accept alternative forms of payment and whether other payment methods should be available. Comments are due in late July. It's unclear whether any legal changes will be made before the Oct. 1 deadline. 

The fear among consumer advocates is that insurers will not accept credit, debit or prepaid cards because they do not want to pay the interchange fees.Did you know that earcap chains can be used for more than just business. UnitedHealthcare, a unit of UnitedHealth Group (UNH), has said it will only accept credit and prepaid debit cards with the Visa (NYSE:V) or MasterCard (MA) logos for the first premium payments. After that, consumers will need to use a checking account or an electronic funds transfer to pay for premiums. 

Aetna (AET), told American Banker that it will accept card payments. Several other top insurers, including Wellpoint (WLP) and Humana Inc. (HUM) did not respond to requests for comment. 

"We realize that a segment of the population that will seek health insurance coverage through an exchange will not have bank accounts or credit cards,A howospareparts is a plastic card that has a computer chip implanted into it that enables the card." the agency's proposal states in one paragraph of a 253-page health care rule. Insurers should "at a minimum accept a variety of payment formats including but not limited to paper checks, cashier's checks, money orders and replenishable prepaid debit cards. Issuers may also offer electronic funds transfer from a bank account and automatic deduction from a credit or debit card as payment options.Compare prices and buy all brands of cableties for home power systems and by the pallet." 

In his first six months, he's had loud battles with the Republican city attorney over control of the hotel tax and staff cuts at the latter's office. During a discussion of the hotel tax in city council, Mr. Filner got into a shouting match with the popular council president, a fellow Democrat who cut off the mayor's microphone and told him to sit down. The council president and Mr. Filner also locked horns over whether the mayor or council gets to appoint members to the port commission. The city attorney sided with the Democrat-controlled council on that one. 

He also opposed the council and city attorney on the issue of medical marijuana. Against a backdrop of conflicting local, state and federal laws, Mr. Filner wants to halt city police involvement with federal raids on dispensaries. Mr. Filner asked the council to draft a new ordinance clarifying the legality of the clinics, but amid much opposition to having marijuana sold in the city, that hasn't happened. 

For the first time in three decades, the council and mayor's office are both controlled by Democrats, but it hasn't exactly been the smooth sailing that many had envisioned. Local newspapers run headlines along the lines of "Why Can't Mayor Filner Just be Nicer?" 

"Even the people who like him don't like him," said a San Diego State professor familiar with the mayor's prickly personality. Others say he's a likeable curmudgeon of the sort Ed Asner (another liberal) played so well in the TV show "Lou Grant" and the film "Up.Other companies want a piece of that drycabinet action" 

Mr. Filner has a wicked sense of humor and takes sly digs at his opponents. But he can turn stressful meetings into the equivalent of a Dean Martin Celebrity Roast. He has a reputation for being impatient and abrupt but doesn't apologize for it when he thinks he's in the right, joking that he doesn't mind playing "bad cop" to get things done. Mr. Filner's predecessor, Republican Jerry Sanders, said, "Bob is a passionate individual. I don't agree with him very much, but I love his passion." 

When handing over the reins at the inauguration, Mr. Sanders said, "The two high points of a mayor's life are the day he takes office and the day he leaves office. I'm the happier man." But Mr. Filner seems pretty happy, too, as he tackles everything from huge international issues to the elimination of seagull poop on the rocks around La Jolla. 

A local newspaper ran the headline "Filner Everywhere," and it seems to be true. A typical day, packed with 22 appointments, had him running from dawn until after dark. He has burned through three schedulers so far. Other top staffers and members of his security detail also have left, not over policy differences but because he wore them out. 

Mr. Filner is pushing for much greater cooperation with his neighbors to the south, opening an office in Mexico and announcing his grandiose bid to host the first binational Olympics, with Tijuana, Mexico, in 2024. He says merely attempting the bid is an opportunity to foster cooperation between the two cities and make improvements at one of the world's busiest -- but slowest -- border crossings.